We participate in the Canadian Dental Association iTrans (ElectronicData Interchange or EDI) to ensure that our insured patients receive prompt payment from their insurance companies. EDI permits us to submit your predeterminations and claims online.
In order to use this system, your insurance company must be connected to CDAnet and you must supply us with your complete current insurance information.
We deal with many insurance companies offering hundreds of different dental plans. Benefits may change throughout the year. We do our best to provide you with accurate coverage estimates based on the information you provide.
Dental insurance policies are limited and often only pay for a portion of the procedure(s) that you may need to have done based on their own schedule of benefits. At times, it is almost impossible to accurately estimate a patient’s insurance coverage. Many insurance companies will not give out fees until after the treatment is completed.
The schedule of benefits that your insurance contract is based on may not be the same as the current Suggested Ontario Dental Association Fee Guide that our office follows. Your employer’s Human Resources Department should have all this information available for you.
An important fact to remember about your dental insurance plan is that it is a contract between your employer or union and the insurance company that has been negotiated as part of your benefit package, not our dental office.
Bring us a copy of your dental benefit plan and we’ll review it with you to ensure you are utilizing your dental benefits advantageously.
If your spouse or partner also has insurance coverage, you may be covered by two plans. This is known as Coordination of Benefits by the insurance industry. Please ask us how to utilize this type of coverage.
Balances not covered by your insurance may be claimed on your income tax return under the medical credit.
As a courtesy to our patients with dental benefit plans, we will submit necessary claim forms to your insurance company electronically. Some forms may have to be mailed by you to your insurance company if they do not accept them electronically.
To avoid delays in reimbursements and pre-determinations from your insurer, please provide us with up to date insurance information. Reimbursements are sent directly to you from your insurance company.